Goulburn Base Hospital

Goulburn Base Hospital
Southern NSW Local Health District
Geography
Location Goulburn, New South Wales, Australia
Coordinates type:landmark 34°44′51″S 149°42′47″E / 34.74750°S 149.71306°E / -34.74750; 149.71306Coordinates: type:landmark 34°44′51″S 149°42′47″E / 34.74750°S 149.71306°E / -34.74750; 149.71306
Organisation
Care system Public Medicare (AU)
Hospital type District
Affiliated university Australian National University
Services
Emergency department Yes
Beds 100+[1]
History
Founded 1833
Links
Lists Hospitals in Australia

Goulburn Base Hospital is a public district hospital located in the city of Goulburn, New South Wales in Australia. The hospital is situated on Goldsmith Street, approximately 1 km (0.62 mi) from the Central Business District. The hospital is operated by Southern NSW Local Health District and serves as a regional referral facility providing a range of general, surgical and some specialist services. It is a teaching hospital affiliated with the Australian National University, based in Canberra.

Services

An 11 bed emergency department operates 24 hours. Goulburn Base Hospital has a 6 bed Intensive Care Unit for adult patients, specializing in high dependency and coronary care. Critical patients who are suffering from conditions the hospital is not equipped to handle are transferred to Canberra or Sydney.[2] A helipad on the hospital grounds facilitates patient transfers and evacuations. A 20 bed rehabilitation ward was opened in 2013.

The Chisholm Ross Centre is a 32 bed inpatient psychiatric unit for patients suffering acute mental health conditions.[3] Other specialist services provided include gastroenterology, ophthalmology a renal unit and a maternity ward. A variety of allied health services are also available on the hospital campus.[4]

History

Origin of the Name

In worldwide usage, a base hospital is a military hospital located a safe distance from the battlefront to which patients from field hospitals are evacuated for follow up care.[5] After World War I, the term was applied in Australia and New Zealand to large rural hospitals, which, by analogy, performed a similar function of providing specialist or follow up care for patients from smaller hospitals. For instance, in 1923, the NSW Minister for Public Health, Mr. Oakes, while speaking at Goulburn District Hospital, specifically proposed[6] the establishment of rural base hospitals:

"There should be large and properly equipped base hospitals in the important centres and cottage hospitals scattered through out the various country districts connecting with the larger institutions when necessary by motor service brigades."

In the following year, at the launching of a building fund for the hospital, reference was made to the need to provide adequate local funds to attract Government support (50% funding) for establishing a base hospital in Goulburn.[7] The first base hospital established in NSW was Orange Base Hospital in November, 1933.

However, a number of subsequent attempts to seek funding to bring Goulburn District Hospital up to base hospital standard were unsuccessful.[8][9] It wasn't until 1940 that Goulburn Hospital was publicly referred to as a Base Hospital. At the 98th Annual General Meeting of the Hospital Committee, a Member of the Board, Mr. W.J. Lewis, was reported, apparently for the first time, as using this name for the hospital[10] by saying:

"...the discussion was the outcome of an earlier reminder to subscribers that the treatment now being given to patients was not confined to Goulburn, but embraced areas within 100 miles radius. Mr. W. J. Lewis: It is the Goulburn 'Base' Hospital."

However, six years later, whatever the practical situation, Dr. R. V. Brotherton, the recent Colonel Registrar of Yaralla Military Hospital, then the largest hospital in the Southern Hemisphere, noted that official status was still not forthcoming.[11]

Finally, in 1951, twenty eight years after it was first mooted, Goulburn District Hospital was gazetted as the sixth Base Hospital in NSW,[12] meeting requirements including averaging more than 100 patients per day, and the provision of a children's ward and pathological, X-ray and obstetric units. The intent of the Base Hospital system was to treat major cases at important provincial centres, instead of sending patients to Sydney. Doctors at smaller centres would send their patients to base hospitals for specialised treatment.

Subsequent changes in health care policies have made the status of the Base Hospital terminology unclear. Although Goulburn remains the largest hospital in the Southern NSW Area Health District,[13] the much larger Canberra Hospital in the neighbouring ACT is where many, more specialised, health treatments are provided. When Orange Base Hospital was redeveloped in 2011, the hospital was renamed Orange Health Service. However, there was significant community protest to return to the Base Hospital title, on the basis that the new name was confusing and that the old name better reflected the hospital's role as a regional hub. Eventually it was decided to use the name Orange Hospital instead. This may mean that if and when Goulburn Base Hospital is rebuilt or relocated its hard won "Base" title will be lost again.

Foundation of the Hospital

The history of what was to become the current Goulburn Base Hospital goes back more than 180 years. Residents of County Argyle petitioned Governor Bourke for the provision of public services, including a hospital, in June, 1832 on the occasion of his visiting Goulburn Plains.[14] Governor Lachlan Macquarie had founded the Rum Hospital in Sydney in 1810 (completed 1816) despite the British Government's refusal to fund it, and established the policy of founding "Convict Hospitals" with funding from the Colony government in regional areas where demand justified this.[15]

The Convict Hospital

A correspondent noted[16] that work on a hospital had commenced by September 1833. Some were unhappy with the result, a complainant in the following year claiming[17] that there was only one room in the facility, with not even a provision for a store or a morgue. He also claimed that the Government funds provided were being wasted, with the contractor seeking a contract variation despite using Government provided labour, possibly convicts.

In October 1836, a visitor to the old town[18] of Goulburn (close to the Mulwaree Ponds - Wollondilly River junction), noted:

"…he [the Police Magistrate] also accompanied us to the new town, about a mile distant, where a few scattered buildings of brick and others of wood, had been erected. One of the latter is an [sic] hospital affording accommodation for about 30 patients. Like other places of this kind, in remote places, it was pretty fully occupied, by stock-men, and others of the lower order; victims of immorality, the scourge of this class, in sequestered parts of the Colony, frequented by the Aborigines."[19]

A subscribers' committee was formed in 1842, and on 2 December 1842 the Governor transferred the "Convict Hospital" (Government hospital) to the committee, with the exception of some medical instruments which belonged to the military.[20] By the second annual meeting in 1844,[21] the committee could report the successful funding and running of the hospital. Subscribers paid an annual fee, and non-subscriber patients paid for care at a daily rate, which in some cases would be paid for by charities in the town. By 1848[22] the Secretary of the committee was a Mr. Kitson, with Captain William Hovell, one of the original petitioners of 1832,[14] chairing the Public Meeting. Debate at that meeting centered on a conflict between those wishing to run the hospital cost efficiently by say, competitively tendering for services and by those supporting the medical staff making appropriate management decisions. One debater highlighted the issue:

"... and with respect to what Mr. Kitson said about the hospital working well, he Mr. D. believed it worked well, but that did not say it could not be made to work better (hear, hear) : be it remembered that the institution was not for the benefit of the medical gentlemen, but for the benefit of the public; the interests of medical men were nothing."[22]

This 1848 report notes the dilapidated state of the hospital buildings and that ₤125 had been put to the erection of new buildings.

The New Charity Hospital

"AD 1849 Goulburn Hospital" - Photographed 1870

A new hospital was completed in September 1849,[23] next to the previous weatherboard structure at the corner of Clifford and Sloane Streets, currently occupied by the Police Station. In contrast to the descriptions of the earlier Government funded building, an observer described it in 1857[24] as commodious and well run. The Rev. Willam Ross served as Subscribers' Committee Secretary for twenty years until his death in 1869,[25] with Captain Hovell continuing as President for some of that time. A similar voluntary hospital business model applied to all general hospitals in NSW up to the 1950s. Despite the privatised charitable structure post 1842, much of the capital and half of the operating losses (shortfall) were being funded by State Government by 1913.[26]

Current Building

Goulburn Base Hospital, Goldsmith Street Entrance, 1889

The current main Goulburn Hospital building was designed by local architect E. C. Manfred in 1886.[27] The official opening by mayor H.S. Gannon opening took place on 12 October 1889 attended by a crowd of about 1,000 residents. The hospital opened with a total of 24 beds - 14 for men and 10 for women.[28] By June 1949, the hospital had grown to incorporate 182 beds, a pathology department and specialized X-ray equipment.[29] A major upgrade to the hospital was constructed in the 1960's, providing room for the majority of inpatient services. By 2013 work had commenced on much needed upgrades, including $20 million in capital works allowing an expansion of the mental health facilities, construction of a new 20 bed sub-acute wing, addition of 3 beds to the emergency department as well as general renovations. A major electrical upgrade was completed as part of the works allowing extra medical equipment to be acquired for the operating theatre and imaging departments.[30]

In 2014 it was announced an upgraded – or even new - hospital for Goulburn could soon be a reality following an announcement of $600,000 towards redevelopment plans by NSW Health Minister Jillian Skinner. “I do have a feeling though from some of my previous visits that part of the core of this hospital cannot be redeveloped because of the load bearing nature of the walls. “So that may mean ‘do we look at a new hospital alongside what is currently here, do we in-fill, demolish part of it, etc’- those are the kind of things that will need to be looked at in this planning process Ms Skinner said.[31]

On March the 10th 2015 Health Minister Jillian Skinner and Goulburn MP Pru Goward announced a re-elected Baird Government will invest $120 million for the major redevelopment of Goulburn Hospital. Mrs Skinner said works will begin on-site in the next term of the Baird Government, if re-elected on March 28.“The need for a major upgrade at Goulburn Hospital is clear, which is why we are making this significant investment to ensure this facility can deliver first-class care for patients well into the future,” Mrs Skinner said. “The upgrade of Goulburn Hospital will include improved capacity through fit-for-purpose infrastructure including the emergency department, intensive care unit and theatres, inpatient services and a comprehensive ambulatory care service. “Planning will continue over the coming months to identify what other services could be incorporated into the redevelopment.” Mrs Skinner said the announcement will have wide-reaching benefits, particularly for the 16,000-plus patients who attend the Goulburn Hospital emergency department each year. “The Baird Government committed $600,000 in its first term to plan the upgrade of Goulburn and in our second term we are committed to this major redevelopment,” “I’ve visited Goulburn Hospital on many occasions and the clinicians and community have been champions of this redevelopment. I know it will benefit them greatly and act as a magnet to attract staff to this region Ms Skinner said. Ms Goward said the funding will mark a new era in health care for Goulburn Hospital. “Goulburn Hospital is a strong thread in the fabric of our community. It is where we have welcomed new life and farewelled loved ones and I could not be prouder we are committing to its major redevelopment today,” Ms Goward said.“This has been a long road and I want to thank clinicians and the community for standing alongside me to champion this redevelopment – the need for it is clear. “Goulburn deserves a state-of-the-art hospital and under the Baird Government that is exactly what we will get.”.[32]

There has been some criticism since that announcement of the lack of progress with planning (for instance, the delayed decision as to the site of the new facilities), and claims prior to the NSW election on 28 March 2015 that the project was fully costed, appearing to be contradicted by announcements after the election of detailed assessments still to be completed.[33]

Controversy

The Chisholm Ross Centre for mental health services has suffered from chronic understaffing[34] since the commissioning of a 12 bed expansion in 2012. For at least the first four months, the extra capacity was totally unutilised because it could not be staffed, though the new facilities were in operation with twelve beds in the older facilities closed. Since then, some of this capacity has been taken up, but nurses continue, three years later, to refuse to work what they claim is excessive overtime, when requested do so by management in order to keep beds open in the absence of the required permanent staff.[35]

Doctors at the hospital have been publicly critical of the facilities and the management. Criticisms in 2014 included that the buildings had been added to in an uncoordinated fashion and were therefore not suitable for modern care, and that management forced surgeons to work in unsuitable operating facilities in order to save money.[36] The former Base Hospital surgeon who wrote this letter to the editor also stated that:

"A recent comment by a politician that the opinion of doctors in Goulburn over the years has been dismissed as simply being self-serving epitomises the problem."

This quotation demonstrates that the controversy around who should best make decisions for the hospital, medical staff or management, continues to rage much as it did in the 1840s.

Statistics

In figures published by the Australian Government's My Hospital website for the 2011-2012 financial year, Goulburn Base Hospital performed 1,400 elective surgeries and handled 16,998 Emergency Department presentations. Waiting times in the emergency department were longer than the national average across all triage classifications. Waiting times for elective surgeries compared favourably to similar hospitals.[37] The hospital's 2010 operating budget was $35.03 million.[4]

References

  1. ↑ "Goulburn Base Hospital". ACT Government Health Directorate. Retrieved 26 January 2014.
  2. ↑ Intensive Care Coordination and Monitoring Unit. "Goulburn Hospital". New South Wales Government. Retrieved 26 January 2014.
  3. ↑ "Goulburn Mental Health Services - Private Members Statement". Pru Goward MP. 13 November 2012.
  4. 1 2 "Goulburn Base Hospital". NSW Health. Retrieved 26 January 2014.
  5. ↑ Unknown. "Oxford Dictionary". Oxford Dictionary. Oxford University Press. Retrieved 1 November 2015.
  6. ↑ "Hospital Maintenance.". Goulburn Evening Penny Post (NSW : 1881 - 1940) (NSW: National Library of Australia). 11 August 1923. p. 2 Edition: EVENING. Retrieved 1 November 2015.
  7. ↑ "LOCAL CHARITY.". Goulburn Evening Penny Post (NSW : 1881 - 1940) (NSW: National Library of Australia). 13 May 1924. p. 3 Edition: EVENING. Retrieved 1 November 2015.
  8. ↑ "HOPES DASHED.". Goulburn Evening Penny Post (NSW : 1881 - 1940) (NSW: National Library of Australia). 14 December 1932. p. 2 Edition: DAILY and EVENING. Retrieved 1 November 2015.
  9. ↑ "HOSPITAL COMMITTEE PERTURBED.". Goulburn Evening Penny Post (NSW : 1881 - 1940) (NSW: National Library of Australia). 14 July 1938. p. 1 Edition: Daily. Retrieved 1 November 2015. STILL NOT GIVEN BASE STATUS
  10. ↑ "THE HOSPITAL.". Goulburn Evening Post (NSW : 1940 - 1954) (NSW: National Library of Australia). 27 August 1940. p. 6 Edition: Daily. Retrieved 1 November 2015.
  11. ↑ "CONSERVING HEALTH.". Goulburn Evening Post (NSW : 1940 - 1954) (NSW: National Library of Australia). 12 March 1946. p. 2 Edition: Daily and Evening. Retrieved 1 November 2015. For ten years Goulburn District Hospital has been endeavouring to secure a pathological unit so that it can be made a base hospital. The fact that the District Hospital has not such status is no credit to the Government or the city. War intervened undoubtedly, but it is time this was rectified and the Goulburn District Hospital given its proper standing in playing its full part in the district's health.
  12. ↑ "GOULBURN BASE HOSPITAL NOW "OFFICIAL".". Goulburn Evening Post (NSW : 1940 - 1954) (NSW: National Library of Australia). 5 October 1951. p. 1 Edition: Daily and Evening. Retrieved 1 November 2015.
  13. ↑ "Southern NSW Area Health District". Health NSW. Retrieved 1 November 2015.
  14. 1 2 "ADVANCE AUSTRALIA Sydney Gazette.". The Sydney Gazette and New South Wales Advertiser (NSW : 1803 - 1842) (NSW: National Library of Australia). 26 June 1832. p. 2. Retrieved 26 September 2015.
  15. ↑ Cummins, C. (1976). "The Colonial Medical Service: The Convict Hospitals" (PDF). The History of Medical Administration in NSW. NSW Ministry of Health (Online: Health Commission of NSW). pp. 24–30. Retrieved 31 October 2015. The development and location of the convict hospitals followed the extension of the settlement beyond Sydney as population demanded. So hospitals were established at Norfolk Island, Parramatta, Liverpool, Windsor, Newcastle, Bathurst, Goulburn and Port Macquarie to provide a total medical service for the convict prisoners or indentured labourers and their military guards in the outposts of the Colony.
  16. ↑ "ROADS.". The Sydney Herald (NSW : 1831 - 1842) (NSW: National Library of Australia). 5 September 1833. p. 2. Retrieved 26 September 2015.
  17. ↑ "Berrima New Gaol.". The Sydney Monitor (NSW : 1828 - 1838) (NSW: National Library of Australia). 23 July 1834. p. 4 Edition: MORNING. Retrieved 26 September 2015.
  18. ↑ Unknown. "Riversdale". Places to Visit. National Trust. Retrieved 18 October 2015. In 1828, where the Great South Road forded the Wollondilly River, a few allotments were surveyed for the township of Goulburn Plains. Of these, the site of Riversdale was granted to Matthew Healey in 1830. He held an Innkeepers’ license in 1832, operating from a slab building. In 1832, Governor Bourke selected another site for Goulburn two miles to the south. Built as a coaching inn and residence in the 1840s, Riversdale is the only surviving building of the ‘Old Township’ as sited by Governor Macquarie.
  19. ↑ Backhouse, James (1843), A narrative of a visit to the Australian colonies, Hamilton, Adams, p. 440, retrieved 18 October 2015
  20. ↑ "NEWS FROM THE INTERIOR.". The Sydney Morning Herald (NSW : 1842 - 1954) (NSW: National Library of Australia). 24 April 1843. p. 2. Retrieved 26 September 2015.
  21. ↑ "COUNTRY NEWS.". The Australian (Sydney, NSW : 1824 - 1848) (Sydney, NSW: National Library of Australia). 15 May 1844. p. 3. Retrieved 26 September 2015.
  22. 1 2 "GOULBURN.". The Sydney Morning Herald (NSW : 1842 - 1954) (NSW: National Library of Australia). 21 April 1848. p. 3. Retrieved 26 September 2015.
  23. ↑ "A GLANCE AT GOULBURN IN ITS EARLY DAYS.". The Goulburn Herald and Chronicle (NSW : 1864 - 1881) (NSW: National Library of Australia). 2 October 1875. p. 2. Retrieved 26 September 2015.
  24. ↑ "A VISIT TO GOULBURN.". Empire (Sydney, NSW : 1850 - 1875) (Sydney, NSW: National Library of Australia). 2 June 1857. p. 2. Retrieved 26 September 2015.
  25. ↑ "THE LATE REV. W. ROSS.". Sydney Mail (NSW : 1860 - 1871) (NSW: National Library of Australia). 23 January 1869. p. 3. Retrieved 26 September 2015.
  26. ↑ Cummins, C. (1976). "The administration of hospitals and charities" (PDF). The History of Medical Administration in NSW. NSW Ministry of Health (Online: Health Commission of NSW). pp. 137–140. Retrieved 31 October 2015. It cannot be stressed too frequently that general hospitals developed as voluntary charities for the indigent poor, and survived essentially on the subscriber system, with irregular Government assistance, during the nineteenth century. .... If approved, and if finance was available, assistance for capital expenditure was provided by the Government, which also met the deficit between income and expenditure on a £1 for £1 basis. line feed character in |quote= at position 193 (help)
  27. ↑ Goward, Pru (10 November 2011). "Private Members Statements - Goulburn Base Hospital". Parliament of New South Wales.
  28. ↑ The Sydney Morning Herald (12 October 1889). "Opening of the Goulburn Hospital". National Library of Australia.
  29. ↑ "Health Services c1950". Southern Tablelands History Matters. 18 January 2012.
  30. ↑ "Minister tours Goulburn and Bowral hospitals". Australian Healthcare and Hospitals Association. 7 February 2013.
  31. ↑ "Healthy outlook for hospital upgrade". Goulburn Post. 24 January 2014.
  32. ↑ "$120 MILLION FOR MAJOR REDEVELOPMENT OF GOULBURN HOSPITAL". Member for Goulburn Pru Goward. 10 March 2015.
  33. ↑ Thrower, Louise (July 8, 2015). "Impatient for a New Hospital". Online (Fairfax). Retrieved 17 October 2015.
  34. ↑ Thrower, Louise (March 20, 2013). "Plenty of Beds but No Nurses" (Online). Fairfax. Goulburn Post. Retrieved 17 October 2015.
  35. ↑ Cole, David (August 31, 2015). "More Beds to Close at Chisholm Ross" (Online). Fairfax. Goulburn Post. Retrieved 17 October 2015.
  36. ↑ Hayman, Jarvis (May 28, 2014). "Base Hospital's Condition is Terminal" (Online). Letters to the Editor: Fairfax. Goulburn Post. Retrieved 17 October 2015.
  37. ↑ National Health Performance Authority. "Goulburn Hospital services provided". Commonwealth of Australia. Retrieved 26 January 2014.
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